Structural Fat Grafting

Serving Chattanooga, Tennessee

t is not often that I identify a new technique in plastic surgery that I think has great promise for the future.  I have been watching the technique of structural fat grafting evolve over the last several years; and, now, I am convinced that it holds great promise for use in both reconstructive and cosmetic surgery patients.

Structural fat grafting is an exacting technique in which fat is harvested from areas of the body where it is plentiful.  The fat then undergoes a processing cycle in the operating room. It is separated from impurities, cleansed, and packaged in small syringes for injection into the sites to be treated. The procedure has been championed by Sid Colman MD in New York. Dr. Colman’s attention to every detail has yielded superb results in a wide variety of problematic conditions.

Fat injection itself is nothing new. Fat has been moved around in pieces and by injection for decades. Unfortunately, the lack of standardization among transfer techniques often led to disappointing results. Fat was unpredictable in terms of its staying power which led to contour deformities after treatment. Noticeable bumps and firm knots were unfortunately not uncommon and could be permanent. However, with the strict technical control described by the “Colman” technique, many of these problems have been dealt with effectively.

More interesting than improvement in results, however, is a new finding discovered among fat treated patients. The structurally grafted fat seems to have the ability to repair damaged skin. This was noted particularly in the treatment of radiation injuries in breast cancer patients. The fat grafted areas tended to soften and return to a pre-radiation texture and appearance.  This regenerative result was also noted in areas of significant soft tissue injuries.

This all sounds like it’s too good to be true, but structural fat grafting does have one down side. It is a piecemeal process. That means that the problem to be addressed may require multiple sessions of grafting to achieve the desired result. That being said, the treatment is quite safe, medically. It typically requires a sedation anesthetic, and is considered a minimally invasive technique. Post treatment down time is dependent on the extent and site of the intervention.

Applications of the technique are increasing monthly. The grafting technique lends itself well to breast deformities caused by cancer treatment. In addition to the radiation scar treatment described above, lumpectomy and partial mastectomy defects can be contoured effectively. Fat is usually removed from sites like the lower abdomen where excesses can be an aesthetic problem. The fat is then injected in small amounts and at multiple levels until the contour defect is improved. About three months are allowed to pass before the site is evaluated for a re-treatment.

Structural fat can also be used where cosmetic injectables are currently in use. This injectable fat leads to a permanent change, and should therefore be used much more cautiously then an injectable which is programmed to absorb. Fat has been used in lip enhancement, the correction of deep facial lining and volume restoration of the cheekbone areas. Fat is also quite good at improving the appearance of aging hands. It not only fills out the thinning hands, but also, improves skin quality itself.

I am confident that as the technique of structural fat grafting matures that its applications will expand significantly.  With careful patient selection and exacting technique, fat grafting can produce remarkable results.

To speak with our cosmetic surgery staff or to schedule a consultation, please call us at (423) 756-7134 or (800) 634-3334 or e-mail us.